Mortality and risk factor analysis for Candida blood stream infection: A multicenter study
| Autor: | Yoshihiro Suido, Kasumi Matsuno, Hiroyuki Shimizu, Kazuo Ide, Yoshifumi Sugiyama, Yukihiro Yoshimura, Hideaki Nakajima, Hideaki Kato |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Male medicine.medical_specialty Multivariate analysis Antifungal Agents medicine.drug_class Organ Dysfunction Scores Multiple Organ Failure 030106 microbiology Antibiotics Antifungal drug Logistic regression 03 medical and health sciences 0302 clinical medicine Japan Risk Factors Internal medicine medicine Humans Pharmacology (medical) Blood culture 030212 general & internal medicine Hospital Mortality Risk factor Fluconazole Aged Candida Retrospective Studies medicine.diagnostic_test business.industry Age Factors Candidemia Odds ratio Middle Aged Prognosis Anti-Bacterial Agents Infectious Diseases Treatment Outcome Female business medicine.drug |
| Zdroj: | Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy. 25(5) |
| ISSN: | 1437-7780 |
| Popis: | Candida blood stream infection (candidemia) is severe systemic infection mainly develops after intensive medical cares. The mortality of candidemia is affected by the underlying conditions, causative agents and the initial management. We retrospectively analyzed mortality-related risk factors in cases of candidemia between April 2011 and March 2016 in five regional hospitals in Japan. We conducted bivariate and multivariate analysis of factors including causative Candida species, patients' predisposing conditions, and treatment strategies, such as empirically selected antifungal drug and time to appropriate antifungal treatment, to elucidate their effects on 30-day mortality. The study enrolled 289 cases of candidemia in adults. Overall 30-day mortality was 27.7%. Forty-nine cases (17.0%) were community-acquired. Bivariate analysis found advanced age, high Sequential Organ Failure Assessment (SOFA) score, and prior antibiotics use as risk factors for high mortality; however community-acquired candidemia, C. parapsilosis candidemia, obtaining follow-up blood culture, and empiric treatment with fluconazole were associated with low mortality. Logistic regression revealed age ≥65 years (adjusted odds ratio, 2.13) and sequential organ failure assessment (SOFA) score ≥6 (6.30) as risk factors for 30-day mortality. In contrast, obtaining follow-up blood culture (0.38) and empiric treatment with fluconazole (0.32) were found to be protective factors. The cases with candidemia in associated with advanced age and poor general health conditions should be closely monitored. Obtaining follow-up blood culture contributed to an improved prognosis. |
| Databáze: | OpenAIRE |
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